Why pump after feeding? Expressing breast milk: when expressing is unnecessary and even dangerous

The question of whether to express breast milk after feeding, worries, if not all, then most young mothers. Opinions on this matter are radically divided.

A few years ago, doctors believed that pumping was necessary, but today experts assure that this is not necessary and this process must be approached very carefully.

From this article you will learn:

Interestingly, in nature, mammals do not get rid of excess milk that the babies have not drunk. Therefore, it is reasonable to ask why people should express it in this case. Isn't it easier to trust nature?

The mother's breast produces as much milk as the baby needs. Failures are possible only in the first days after the baby is born, since the body has not yet received a signal about how much milk needs to be produced. However, after a few days this process normalizes, and the endocrine system regulates the amount of baby food produced by the mother’s body.

If you fully express milk after feeding, your body will receive a signal that it needs to produce more. It turns out to be a vicious circle.

However, if you feel discomfort and feel like your breasts are petrified, then you need to remove the excess a little. But just enough to feel relief.

However, there are situations when it is absolutely necessary to resort to this procedure. And this is not only the first days after childbirth, but also in other cases.

Let's look at them in more detail:

If the baby does not want to or there are some other reasons why he cannot take the breast. Then you will have to pump in order to feed the baby later. This can be done with a syringe, from a spoon and in other ways. In this case, pumping maintains normal lactation.
If you are sick and temporarily cannot give your baby the breast, then you need to pump so as not to lose milk later. It is much easier to save it now than to try to restore it later.
Sometimes there is hyperlactation, that is, the body produces excessive milk - much more than the baby needs. But in this case, you should first of all understand the causes of hyperlactation and undergo an examination. Sometimes it is excessive pumping after feeding a newborn that leads to hyperlactation. Therefore, this process must be gradually slowed down. For example, use the so-called “regime pumping”, that is, do not remove the remaining milk after feeding at night, and then gradually abandon this procedure after daytime feedings.
If for some reason mother and baby cannot spend the first days after birth together, then difficulties may arise. So, in medical institutions, the baby is often brought to the mother strictly on schedule, for example, every 2 or 3 hours. But at such moments, the baby does not always feel the need for food; he may simply fall asleep during feeding, and be hungry in the intervals between them. This is also bad for the mother, as there may be a shortage of milk or its excess production. Then for relief you need to pump a little.

Be careful, lactostasis!

Lactostasis is a blockage of the milk duct. As you know, a woman’s breast is divided into lobes, and each lobe has ducts. Sometimes it happens that the duct is pinched and because of this a plug appears, preventing the milk from coming out. Then swelling appears and pain occurs. When you press, you can see that milk comes out of one part of the nipple more slowly than from the other or does not come out at all.

Lactostasis can occur due to feeding disorders or due to chapping of the breast. It is often accompanied by a slight increase in temperature and is reminded of by a feeling of heaviness. Sometimes the reason is:

tight bra
sleeping on your stomach
squeezing the breast during feeding, that is, actually improper feeding.
nipple abnormalities
stress, lack of sleep
injuries, bruises
insufficient fluid intake.

As you can see, there are many reasons, so no one is immune from this disease. If you have such symptoms, then it is not only possible, but also necessary to express your breasts after feeding.

You can put your baby to your breast more often, for example, once an hour. If your baby has a good appetite, you will feel relief within 24 hours. Or you can additionally pump 2-3 times a day, but no more, as this can provoke increased milk production, and again there is a risk of blockage of the ducts.

If you do not pump and do not put the baby to the breast, then lactostasis goes into the next stage - mastitis.

By the way, if your temperature rises, this will not affect the quality of your milk, so you can safely put your baby to your breast a little more often.

How to properly pump after feeding your baby

This can be done different ways. Once upon a time this could only be done with your hands - our mothers and grandmothers still remember this. This method requires some skill and time. Breast pumps are much more popular today.

Devices are also divided into types and are:

mechanical;
electric.

They are much easier to use. Before the procedure, wash your hands, wipe your breasts with a sanitary napkin, and lightly massage your breasts and nipples. Place the nipple into the breast pump so that the nipple is in the very center.

After use, you must completely disassemble the device, rinse it in warm water and disinfect it. However, this is not difficult to do, since modern milk pumps are as simplified as possible in terms of design.

If you do not yet have sufficient dexterity, it is recommended to seek help from a lactation consultant. Just one consultation will be enough for you, and in the future you will be able to quickly and correctly express milk after feeding your newborn on your own.

Expressing milk is one of the issues on which there is a lot of disagreement. A nursing mother usually has to listen to more than one point of view: someone says that milk must be expressed after each feeding; someone, on the contrary, believes that there is no need to do this at all... How to figure all this out?

Technique

When a mother expresses milk, the same mechanisms are activated as when feeding a child, but weaker - after all, pumping is only a “manual imitation” of the natural feeding process. However, in both cases, the hormone oxytocin acts first, which helps milk to be released, and during pumping itself, the hormone prolactin is produced, on which the amount of milk depends. From here follow two important rules pumping that a nursing mother needs to know:

In order for milk to be expressed well, you need to help the oxytocin reflex;
Expressing itself provokes further milk production.

In order for the oxytocin reflex to work - which means milk is released well - the mother can drink something hot 10 minutes before feeding; warm up your chest - put a towel soaked in warm water on it, for example, for five minutes, or take a warm shower; and, of course, relax - think about the baby, how nice he is, how wonderful it is that he is fed with your milk. You can lightly massage your breasts, shake them a little, leaning forward, so that the milk flows out more easily under the influence of gravity. Working mothers often carry a photograph of their baby with them and look at it with tenderness, feeling the milk flow. And then you can begin the pumping process itself.

Technically, hand expression looks like this. Place thumb on the upper border of the areola (or approximately 2.5-3 cm from the nipple), and the index and ring fingers - opposite it, on the lower border, so that the fingers are in position 6 and 12 hands on the clock. Squeeze your breasts slightly back towards your chest, then roll them forward and, when the milk is squeezed out, relax your fingers. Do it all again. Move your fingers in a circle so that the milk comes out of all the lobes.

Breast pumps

“Pear” is the simplest and at the same time the most ineffective. The mother is expected to pump milk by squeezing and releasing the rubber bulb. Its only advantage is its low cost, but there are many disadvantages: starting from the fact that it is difficult to wash and sterilize it properly, and ending with the fact that such breast pumps often injure the breasts until cracks occur. There are women for whom this model is suitable, but there are very few of them - about one mother out of every ten can pump out milk well with a “pear” without damaging the nipples.

A cylindrical breast pump consists of two cylinders, one of which is nested inside the other, and there is a rubber gasket between them. Milk suction occurs when the internal cylinder moves.

This suction is easy to use (you can even use it while lying on your side), it is easy to clean - even a dishwasher can handle this, just be sure to wash the gasket by hand. Among the disadvantages are that some women experience pain when expressing, and if milk gets on the pad, the device begins to work poorly.

A lever breast pump is usually very easy to use, painless and silent. Of the models of this type, it is best to choose a breast pump that has massage attachments and can imitate the baby’s sucking process in terms of suction strength and speed. Some models even allow you to express milk from both breasts at the same time - of course, they are more expensive, but they save a lot of time.

Battery-powered or electric breast pumps work automatically, just press a button. Battery-powered suction devices work somewhat worse and slower, are often noisy and require battery replacement every two to three days. An electric breast pump is perhaps the best thing a Russian woman can buy on her own today.

There are also professional medical breast pumps, which are very expensive, but they can be rented abroad for the required period. In Russia, this service, alas, is very little developed.

When choosing a breast pump, also decide how you will use it: regularly take it with you to work (compactness and ease of washing are important); use occasionally at home; use a short time and so on.

When should you pump?

When should you express milk? Of course, not always, but only when necessary. All cases when pumping is necessary are divided into two categories:

Mom has too much milk and needs to get rid of its excess;
the mother has a need to supplement the child's feeding.

It is clear that in the first case there is no need to be zealous - we remember that pumping leads to an increase in milk production! Therefore, if the breast becomes engorged, lumps appear in it, which the child is not able to cope with, then we express the milk, but only until the breast becomes soft. There is no need to strive to express milk “to the last drop”, because in this case more and more milk will arrive, and coping with its excess is sometimes more difficult for a mother than with a deficiency... Members of the International Association of Breastfeeding Consultants had to work with a case where the mother, who pumped “to the last drop” from the very maternity hospital, in addition to feeding the child, also pumped three liters of milk every day! So if the problem of decreasing milk supply is acute for you, try to express less and less each time. You can seek help from lactation consultants who can provide advice tailored to your personal situation.

The second case is when the mother needs:

leave milk for the baby while you leave;
transfer milk to the children's department of a maternity hospital or hospital;
increase milk production in this way (then the expressed milk is also fed to the baby);
or supplement feeding of a child who sucks sluggishly and is not gaining weight well. In all these situations, the mother tries to express as much milk as possible.

If your baby sucks well, feeds on demand, the breast remains soft and does not become engorged - no additional pumping is needed!

Practice

Here we will answer some questions that mothers ask consultants both in the maternity hospital and after it.

“During his rounds, the doctor presses on my chest, and a stream of milk comes out, and when I try to do the same, a drop runs out of me... Am I doing something wrong?”
Not at all necessary! Most first-time mothers, and many multiparous mothers, leak milk in drops during the first 7-10 days after birth. Mothers sometimes want to achieve results “like a doctor’s”, but do not pay attention to the fact that it usually hurts. And if someone begins to work hard, not paying attention to the pain, just so that the milk flows out better, there is a danger of simply damaging his breast. Take your time, after just a few days you will notice that you are making the same efforts, and the milk that was previously only dripping begins to flow out in streams - and without pain!

“I’m thinking about whether I should buy a breast pump. My roommate bought a cheap one, and it doesn’t work out for her, but it’s a waste of money to buy an expensive one, because with a newborn there are a lot of other expenses. Is it possible to do without a breast pump?”
This is a personal choice for every woman. Most mothers do without a breast pump at all, especially if frequent regular pumping is not expected (and they are needed, for example, when the baby is separated from the mother for a long time or the mother is going to go to school or work early). But if you are not good at expressing with your hands or want to save time on this process, then keep in mind that the simplest and cheapest suction models (with a “bulb”) are suitable for a very small number of women. The optimal models of breast pumps today cost from $60 and above.

"When I try to express milk, I don't produce much milk. Does that mean my baby is starving?"
Even if nothing comes out at all when you press on the breast, this does not mean anything if the baby is sucking at the breast, looks calm, pees often (8 or more times a day) and gains weight. After all, the baby and the breast were originally meant for each other, and neither a breast pump nor your hands can empty the breast as well as your baby!

“If I don’t pump every day, I will end up with milk in my breasts and get mastitis!”
As for such a “scarecrow” for mothers as mastitis, its cause is an infection (usually introduced from the outside, for example, through cracks in the nipples) or very long stagnation of milk (mastitis from its own flora develops on the sixth day after the onset of stagnation). If the milk just “stays in the breast”, it’s okay, the baby will simply suck it out at the next feeding. But if the mother constantly pumps unnecessarily, thereby provoking constant excess milk, this represents a much greater risk factor for the occurrence of stagnation. After all, the best prevention of congestion is not pumping, but to ensure that as much milk is produced as the baby needs!

Once upon a time, all pediatricians and obstetricians insisted that a nursing mother should express the breast to the last drop after each feeding of the baby. What has changed these days? Should a nursing mother pump or is it better to forget about this procedure altogether?

The answer may not be clear-cut, since everyone’s feeding situation is different. And regular pumping has both pros and cons.

pros

Pumping helps the mother maintain lactation away from the baby, for example, if the mother went to school, went to the hospital, or started working.
By receiving expressed milk, you can feed mother's milk through a tube to babies who were born prematurely or are in the hospital.
Pumping helps alleviate the condition of a nursing mother if a lot of milk has come in and stagnation has occurred (this often happens during the period of lactation). In this case, the mammary glands need to be pumped only a little to eliminate painful overcrowding.
Mom will have to express milk during the period when she is sick and takes medications passing into breast milk.
If a child is not gaining weight well, pumping after feedings can become an additional incentive to increase lactation.

Minuses

Although doctors previously recommended pumping to prevent milk stagnation and mastitis, pumping is one of the provoking factors for these conditions.
The possibility of getting into a vicious circle: due to the large number of pumping, too much milk will be produced. To remove the heaviness in the chest, the mother will be forced to constantly pump.
Mom gets tired of pumping and begins to consider breastfeeding an unpleasant and difficult process.

What's happening?

When the mother gives breast to the baby on demand, the baby sucks the portion of milk he needs. Sucking stimulates the production of exactly as much milk for the next feeding as the baby ate.

If the baby's appetite has increased and the breast is empty, greedy sucking will become a reason to develop more nutrition in the breast for subsequent feedings. If the baby has eaten less and some of the nutrition remains in the breast, milk production will not be as active at the next feeding.

With more frequent and prolonged feeding of the baby to the breast, lactation will be stimulated. Pumping is also such a stimulus for lactation - the more milk a woman receives from the breast, the more milk will come.

When is pumping necessary?

Separation of mother and child if a woman wants to maintain lactation.
A weakened or premature baby cannot suck out the required amount of milk to stimulate lactation.
Resumption breastfeeding after the break.
The mother goes to work if the child is less than 8-9 months old.
Milk stagnation to relieve breast congestion.

If the baby was born full-term, actively sucks, the mother feeds the baby on demand and the mother’s breasts are not full (there is no congestion), in this case pumping is not necessary either after feeding or at any other time.

How much milk should I express?

The amount of human milk that can be obtained when expressing may differ at different times:

Pumping “to the last drop” is recommended for mothers who want to stimulate lactation as much as possible.
If a mother stores milk for future use, she should try to express as much milk as the baby needs for one feeding.
During stagnation, it is recommended to express a small amount of milk just to alleviate the condition and relieve breast tension.

After each feeding

Previous recommendations for all women to pump their breasts after each feeding of the baby are no longer supported by pediatricians. This was once explained by the need to constantly stimulate lactation. However, if breastfeeding is done correctly, the woman's breasts do not need additional stimulation other than the baby's latches. Expressing only increases the “demand” for milk production, which can be detrimental (cause lactostasis or even mastitis).

“If you want to breastfeed, don’t be lazy and express milk after every feeding!” - For many decades, doctors professed this doctrine, believing that it is a prerequisite for good lactation and healthy mammary glands in the future. The confidence in the need to express breast milk was so great that mothers spent all their time doing it from one feeding to the next, complicating their lives.

Do I need to express milk?

The myth about the total benefits of diligently expressing breast milk is based on the observation that if you “take away” every last drop of milk from your breast, more of it will come. But this rule has other characteristics. Firstly, it only works with one-time use: if after morning feeding the mother expresses her breasts to the last drop, then the next day more milk will actually accumulate. If the woman does not repeat the procedure, the volume will gradually return to normal. The second circumstance: when the baby suckles on his own, the amount of milk produced and consumed is approximately the same. By expressing valuable fluid, a woman upsets the natural balance between the baby’s needs and the amount of milk produced. They always express more than the baby would eat, so by the next feeding too much milk will come, the breasts will become full, but the baby will still not eat more than he needs. If you do not express the remains, there is a risk of lactostasis. Mom gets to work, and in response to her efforts, more milk will come again than needed.

A vicious circle of expressing breast milk will form, which cannot be broken painlessly. Milk that is not demanded by the baby is a signal for the pituitary gland to reduce the production of hormones responsible for breastfeeding. The answer will be to reduce the amount of “baby food”. Noticing that there is less milk, the mother takes action: she spends even more time pumping, stretches out the breaks between feedings to “accumulate milk”, introduces supplementary feeding...

As a result, the baby suckles even less, and the mammary gland is deprived of the natural stimulation it needs. The normal feeding scenario is disrupted, and the baby gradually becomes artificial... The conclusion is obvious: continuous pumping is fraught with complications, and it is better not to start it. It leads to stagnation of unclaimed milk, which threatens the health of the mammary glands and interferes with normal lactation.

When should you express breast milk?

But you shouldn’t completely exclude expressing breast milk from the life of a young mother. A normal breastfeeding cycle for a baby lasts at least 1 year. During this period, a nursing mother will more than once find herself in circumstances where pumping is indispensable. Three situations are repeated more often than others, and each involves its own pumping tactics.

Story one. First arrival of milk.

Usually milk appears in the breast on the third day after birth. And it’s not always possible to guess how many will come. Sometimes the proceeds are so large that most of them remain unclaimed by the newborn and complicate the life of his mother, who has not yet recovered from childbirth. A woman’s breasts increase in size, become heavy, and if pressure is applied to the glands, pain is felt, they lose their usual softness and become rough. If measures are not taken in time, inflammation develops: the temperature rises, and health worsens.

What to do? For engorged breasts, a compress of cabbage leaves helps a lot. It gives a cooling effect by absorbing evaporation from the surface of the skin. Wash several large fresh cabbage leaves with warm water and cover the entire gland with them for about an hour. The next point of assistance should be gentle massage and pumping. One or two sessions will soften the breasts, helping to normalize milk production.

Since at the moment of rapid milk flow the breasts become very painful at the slightest touch, you need to prepare for pumping. Start by massaging the least affected areas, gradually expanding the affected area. Try to relax, take long exhalations - this will help bring the mammary gland out of the state of “shock”, then the elastic muscular tubes - the milk ducts - will begin to contract more actively, and the milk will flow on its own.

After 7-10 minutes of massage, try placing a pinch of your fingers on the areola and rhythmically squeeze and unclench them several times. If a drop of milk comes out, start expressing - manually or with a breast pump; if not, continue the massage.

When expressing milk with your hands, place your palm with four fingers under your breast so that your index finger is on the areola from below, and your thumb is on top. When you squeeze all your fingers, the nipple should move forward. Now lift your breasts, press them against your chest and squeeze and unclench your fingers around the areola several times. If milk starts to flow, continue pumping until the flow ends. To ensure that the lobules of the gland are emptied evenly, move your fingers around the circumference of the areola.

Important details. Expressing with a breast pump has an important advantage: the resulting product is easier to preserve, because the milk goes directly into a sterile bottle or bag for freezing milk. When working with your hands, some valuable liquid splashes out. When trying to express milk for future use, do not get carried away. Pumping too excitedly will lead to even more milk tomorrow, and you will wake up with sore breasts again.

The second story. Stagnation of milk leads to lactostasis.

First, the mother discovers a small lump in the breast, which, when pressed, hurts, as many women say, like a bruise. With lactostasis, the milk ducts, which are supposed to push milk out, lose their elasticity and stop contracting. No more fluid is produced than usual, but it cannot escape. If you do not take action, redness will appear. If you continue to do nothing, mastitis will begin - inflammation of the mammary gland.

What to do? An excellent remedy for treating lactostasis is pumping. It should begin with a similar chest massage - it will soften the lump, restore blood flow in the stagnation zone and activate sluggish ducts. Painful sensations should be avoided: the response to pain will be an even greater spasm of the ducts and worsened lactostasis. The entire gland should be massaged - not too much, but quite deeply. First, make several stroking movements along the gland from the periphery to the nipple, lift it, tap your fingers from below, from the side, approaching a particularly sore spot. To make your fingers glide better and not injure the delicate skin, apply nipple cream to them.

Important details. You should start pumping when you feel a rush of milk (usually heaviness, itching, or tingling appear in the chest) or you see that it has begun to drip. You can express by hand into a wide bowl, leaning over a low table: this puts the breasts in a position that stimulates outflow.

Story three. The child is not gaining weight

The baby is already a month old, he sucks normally, and nothing bothers his mother. But at the first visit to the doctor, it turns out that the baby has hardly gained any weight in a month. It turns out that he doesn’t have enough food and urgently needs additional feeding? The reason for the misunderstanding is that an inexperienced mother cannot always determine when her child is simply sucking on the breast like a pacifier, and when he is eating. She doesn’t notice that the baby just lies with the nipple in her mouth, smacking her lips, and doesn’t swallow anything. This behavior creates a sluggish milk order. If you put up with this tactic, then pretty soon the breast will empty, the baby will turn away from it, and lactation will stop almost immediately.

What to do? Milk is released in waves in response to the baby suckling at the breast. It is advisable not to allow long breaks between tides. If the baby falls asleep at the breast, shake him, lift him to a vertical position for a few seconds, offer one breast or the other. To activate the flow of milk, you will have to spend free time for stimulating massage and pumping. At first, you need to spend several hours a day on these procedures: 3-4 sessions of 30-45 minutes each will be required. After a few days you will notice an improvement and the duration can be shortened. During massage and pumping, you should be comfortable: sit comfortably, turn on calm music, tune in to pleasant thoughts about the baby. Breast massage - stroking, shaking, tapping - should be alternated with squeezing and unclenching the nipple for 1 minute. As soon as the gland becomes softer, express some milk and start feeding.

Important details. Your task is not to express a large amount of milk; save the main portion for the baby. After all the effort, he would probably finally be able to eat lunch on his own.

If mom manages to collect milk by expressing it as needed, then sooner or later she will be able to create her own “milk bank” in the freezer. The product will definitely come in handy when you need to go away for a long time or take medication that is incompatible with breastfeeding.

It is worth preparing for the rapid arrival of milk. A day after the birth of the baby, you should limit your fluid intake - drink little by little and only still water. Soups, tea, compotes aggravate thirst. When milk production returns to normal, the restrictions can be lifted.

Rada Melnikova, breastfeeding consultant, member of the SPPM, graduate of the ProgV Project www.progv.ru: You can still sometimes hear advice to a young mother to express her breasts “dry” after each feeding. The most varied arguments are given: so that the milk does not disappear, so that there is no stagnation, “I did this, and only thanks to this I fed it!” Indeed, in the middle of the last century there were such recommendations. There was a good reason for them: after all, another recommendation was widespread at that time - scheduled feeding. The baby was put to the breast 6-7 times a day with a long night break. As a rule, one feeding is one breast, so the baby was attached to each breast 3-4 times a day. Feeding at such a rhythm is critically insufficient stimulation of the breast for milk production. Regular pumping in this case made it possible to at least somehow support lactation.

If the mother feeds the baby on demand day and night, does not limit the duration of feedings, latches to the breast for 12 days or more, the baby gains weight and develops according to age standards, then there is no need for additional pumping!

Milk production is a law of supply and demand: the more milk is removed from the breast, the more milk is produced, and vice versa. If a mother regularly pumps her breasts, the body perceives this as a signal that the baby needs more milk than he actually sucks. This can easily lead to hyperlactation, and too much milk is no more pleasant than its lack, and can lead to stagnation, inflammation in the mother, and digestive problems in the child.

WHEN PRESSURE CAN HELP

However, there are situations in which pumping can be very helpful. Here are the most typical ones.

1. Pumping in order to establish lactation and feed a child who, for some reason, cannot yet suckle at the breast (low birth weight, premature newborn, a child with anatomical structural features that make sucking difficult, other special situations when it is difficult for a child to suck effectively).

2. Pumping to alleviate the condition of severe fullness or engorgement of the breast, when it is difficult for the child to take a full breast.

3. Pumping to maintain lactation and feed the baby if the child for some reason refuses or cannot temporarily attach to the breast (breast refusal, illness of the child).

4. Pumping to increase milk supply when really needed.

5. Mom goes to work or needs to leave home (regularly or from time to time).

6. Expressing in case of stagnation of milk.

7. To maintain lactation if the mother is forced to be separated from the child for some time.

HOW OFTEN SHOULD YOU PRESSURE?

Each situation is individual and the best solution will seek help from a lactation consultant. The specialist will develop an individual pumping scheme and teach pumping techniques.

1. To establish lactation, if the baby after birth for some reason cannot suckle, it is necessary to start pumping as soon as possible. Preferably within the first 6 hours after birth. At first it will be just a few drops of colostrum - the first milk that is in a woman’s breast immediately after childbirth.

Then you need to express approximately in the rhythm of the baby's latches to the breast. At least once every 2-3 hours, including at night. Try to get at least 8 pumpings per day.

If night pumping is difficult to accomplish, one break of 4-5 hours is possible.

Nighttime pumping is very important for adequate milk production! Try to have at least 1-2 pumping sessions between 2 and 8 am.

Rare pumping or its absence in the first days, if the baby is not latched to the breast, can interfere with the normal development of lactation processes and provoke insufficient milk production in the future.

2. To maintain the amount of milk in the mother, if the baby is temporarily not attached to the breast, it is advisable to express at approximately the same rhythm in which the baby sucked or a little more often, since no breast pump can stimulate the breast as effectively as the baby.

But no less than once every 3 hours for a child under 6 months.

3. Regardless of how much time has passed since the last pumping, it is necessary to express a little, until a feeling of relief, if the mother feels too full. Even if, according to the developed scheme, the time to express has not yet come.

4. When working to increase milk supply or create a milk bank, everything is very individual and depends on the specific situation. Consult a specialist!

5. If you can’t pump as often and for as long as planned, it is important to remember that any breast stimulation is a “request” to the mother’s body to produce milk. Even 5 minutes of pumping is better than nothing. A child in the first months of life can be attached to the breast up to 20 or more times a day and suck from a few minutes to 1 hour or even longer. If it is not possible to express at a certain rhythm, simply express at any convenient opportunity.

WHEN TO EXPRESS. EFFECTIVE SCHEMES.

There is no single algorithm here either; a lot depends on the situation. General principles such.

1. If the baby is attached to the breast, then you need to express immediately AFTER feeding or 30-40 minutes after it (that is, between feedings), and not before. There are situations when it is acceptable and even necessary to express before feeding, but these are special cases and should be recommended by a specialist. In the vast majority of cases, it is advisable to express after the baby has fed well from the breast.

2. It is very effective to express one breast while feeding the other breast, since the baby stimulates the flow of milk in both breasts by sucking.

3. The most effective pumping mode is “5+5…1+1”: first 5 minutes on one breast, then 5 minutes on the other, then 4 minutes on each breast, then 3, 2 and finally 1.

4. Simultaneous expression of both breasts also stimulates milk secretion and milk production very well (this can be done either with a breast pump designed for simultaneous expression, or manually, after some training).

5. Usually one pumping session takes 15-20 minutes for each breast. If you are working to increase your milk supply, continue pumping for another 2-3 minutes after your milk has stopped coming out.

6. Sometimes mothers combine two types of pumping - first they express with a breast pump, and then a little more with their hands. This often allows you to express more milk.

7. Don't think too much about expressing a lot of milk. Practice shows that if a mother expresses without looking into the container or counting milliliters, she manages to express more milk.

IMPORTANT! The baby creates a stable vacuum and performs a whole range of movements (almost all facial muscles are involved in the sucking process) to extract milk. When expressing by hand or with a breast pump (even the best), it is impossible to completely imitate the baby’s actions. Pumping is a skill! The volume of expressed milk cannot judge whether the mother has enough milk.

Pumping technique

What to express?

What is the best way to express - with a breast pump or by hand? Each option has its supporters. If you are expressing milk for the first time in your life, try doing it manually. It is easier to control the process with your hands and stop immediately if the sensations become painful. By expressing with your hands, you can study the characteristics of your breast, choose effective pumping movements, speed and compression strength.

A breast pump is usually easier to use when your breasts are full. It may be less effective if your breasts are soft.

Some mothers note that immediately after giving birth, expressing with your hands is much more effective than using a breast pump.

There are women who, due to the characteristics of their breasts, cannot express a single drop with a breast pump, but they can do it just fine with their hands. Try and find your own option.

If you have to express regularly, you should consider using an electric breast pump. The best electric breast pumps are clinical devices and those that express both breasts at once.

Avoid using the simplest “bulbs” - breast pumps: they can easily injure your breasts, and the efficiency of pumping is low.

Never use a breast pump if your nipples are cracked or swollen! This may make the situation worse.

Preparing to pump.

When expressing milk, the same processes are launched in the body as when feeding a child, but weaker - after all, expressing is only an imitation of the feeding process. However, both during feeding and during pumping, the level of the hormone oxytocin, which helps milk flow from the breast, and prolactin, which is responsible for milk production during lactation, rise.

To make milk flow more easily from the breast, you can help the “oxytocin reflex” start working before you start pumping. Here are actions that can help you relax, calm down, and thereby promote easier milk release and effective pumping.

1. Before you start pumping, wash your hands and prepare everything you may need during the process (container for pumping, warm drink and snack, napkins, phone, book, etc.)

2. Sit comfortably, relax, you can turn on quiet, calm music.

3. To stimulate milk secretion, you can use a light breast massage: “tapping” with your fingertips, stroking, fingering “like lotto barrels in a bag”, you can “shake” your breasts a little, leaning forward, and lightly move your fingers from the periphery to the nipples. It's a good idea to stimulate your nipples for a while by lightly pulling or rolling them with your fingers (just be very gentle!).

IMPORTANT! Any action should not hurt you!

4. It’s very good to drink some warm drink before you start pumping. What exactly is not important, it should be tasty for you :-).

5. If there is no fever or inflammation, you can immediately warm your breasts for a few minutes before pumping - for example, put a towel soaked in warm water on it, or take a warm shower. You can warm your hands and feet in the water.

6. If possible, have someone close to you massage your neck and back - this will help you relax.

7. If the child is nearby, skin-to-skin contact helps, look at the child, touch him, hold him in your arms.

8. If the child is not nearby, you can look at his photo or keep some of his clothes nearby. Give free rein to pleasant thoughts about your child.

9. During the process of pumping, some mothers imagine a running stream of water, waterfalls.

You may feel the milk ejection reflex kick in or notice milk flowing from your breasts, but you may not feel anything. You don't need to know or feel this reflex to produce milk.

Expressing by hand.

1. Place your thumb above the areola (or about 2.5-3 cm from the nipple) and your index finger opposite your thumb under the areola. The remaining three fingers of the hand support the chest.

2. “Roll” your fingers a little, place them a little higher or lower, feel the “peas” under your fingers (they are located approximately on the outer border of the areola). These are the ones that will need to be influenced (they can’t always be felt. If you don’t feel anything, don’t worry, just keep your fingers approximately on the outer border of the areola). There is no milk in the nipple! 🙂

3. Lightly squeeze your chest with your thumb and forefinger, towards the chest, as if pressing your fingers a little inward.

4. Roll your fingers forward and when the milk is squeezed out, relax your fingers. Do it all again. Important: fingers should not move over the skin, they should remain in one place. They don’t move, but rather “roll” across the chest!

5. For the first minute or two, until the milk release reflex starts, it may be released very weakly (or not at all), it is important not to stop rhythmic pumping movements.

6. When the milk has stopped actively flowing out, move your fingers a little along the border of the areola and continue expressing. From time to time, move your fingers in a circle so that all segments of the breast are emptied evenly (with the exception of targeted pumping of a certain lobe during stagnation of milk).

7. It is good to alternate direct pumping movements with additional stimulation. If you see that the flow of milk has slowed down after the end of the flow, you can:

put the baby to the breast (if possible),
drink something warm
give a light breast massage and then continue pumping.

If you feel the “hot flashes” well, then you can be guided by the fact that during the 1st “flush” about 45% of the milk comes out of the breast, the 2nd flush – more than 75%, the 3rd flush – more than 94%.

If not, then just use the pumping time as a guide (about 15-20 minutes for each breast).

Expressing with a breast pump.

1. Read the instructions carefully: is the breast pump assembled correctly, are the parts in contact with the breast and milk clean?

2. It is important to choose the nozzles that exactly match the diameter, otherwise milk may be expressed painfully or ineffectively, and cracks or swelling of the nipples may occur.

3. If the breast pump has several power levels, start with the minimum to avoid nipple injury, and then gradually increase the power until it is comfortable, but not painful.

4. Stop pumping immediately if it hurts! Further:

make sure that the nipple is exactly in the center of the nozzle and that it is the right size for you,
reduce power,
Don't pump for too long, take breaks.

WHAT TO DO WHEN “THE MILK HAS COME”?

Separately, you need to talk about the correct actions at the moment the milk comes in (usually on the 3-5th day after birth). Many mothers, even before giving birth, hear stories that “on the third day my milk came in, my breasts became just stone, everything hurt, the baby couldn’t suck it out, they could barely pump it out!” And what a pain!” And this very arrival of milk and straining “until the stars in her eyes”, the mother begins to expect with fear. Meanwhile, with the right actions after childbirth, you may not feel anything at all when the milk comes in, or the sensations will be quite comfortable and the breasts will simply become fuller. What should these actions be?

1. The most important thing to do is to ensure that milk is removed from the breast from the first hours after birth. This is done by putting the baby to the breast at least once every 2-2.5 hours or by pumping, as described above.

If the first milk, colostrum, is not removed from the breast before the arrival of a large amount of milk, then in the future it literally becomes a plug that interferes with the outflow of milk from the breast (as it has a thicker consistency).

2. The key to removing milk from the breast is effective sucking. Make sure your baby has a good latch and is sucking milk, rather than just holding the breast in his mouth.

Here are signs that everything is fine:

baby's mouth is wide open (obtuse angle 120 degrees or more),
both lips are turned outward,
the tongue covers the lower gum,
in the mouth not only the nipple, but also most of areolas,
the cheeks are round, not retracted,
the baby's chin is pressed to the chest,
You do not hear any extraneous sounds when sucking,
It doesn't hurt you,
when the baby releases the breast, the nipple is round or slightly oval (not flattened, no creases or slanting).

3. Continue to attach the baby at least once every 2-2.5 hours or express (if it is not possible to attach the baby) after the milk comes.

4. If a lot of milk comes in at first (and this is normal in the first days), and the breast becomes full to the point of discomfort, you can sometimes pump for 3-5 minutes, “until relief” between the main pumpings, if the baby does not attach to the breast . Or latch on to your baby more often, if possible.

5. Between pumping or feeding, you can apply a cool compress (for example, a diaper soaked in cool water). It relieves discomfort and swelling well.

IMPORTANT! Any manipulation of the breast should not hurt you! Under no circumstances should you aggressively massage, knead lumps, or express painfully. These actions have nothing to do with the release of milk from the breast, but can lead to injury to the mammary gland and the development of inflammation.

You can massage very carefully and put the baby to the breast more often or carefully express (if it is not possible to put the baby on).

6. If you realize that the situation is out of control:

your breasts are very full, painful and you can’t cope with it,
It hurts when your baby sucks
When I express, the milk does not flow out, and it hurts to express.

Seek qualified help!

You can call toll free hotline breastfeeding support, for example, here:

And also ask for help.